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Millennial Students: The Good, the Bad, and the Ugly (Born between 1982 through to today) They tend to: not to learn from failure.  idealistic—hopeful of the future have increasing levels of stress and anxiety be more nurtured than previous generations.  parents tend to be overprotective and highly involved  exposed to more structured upbringing  Greater expectation for personal and immediate resolutions have been raised by parents believing in the importance of self- esteem have been pushed to study hard and succeed  to choose careers that “pay off” nicely multi-task well  having juggled sports, school, and social interests as children

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Millennials contd. be quite interdependent (i.e. on friends, family, teachers/role- models) be more inclusive and tolerant of religions, ethnicity and sexual orientations have exposure to vast information but go less in-depth acknowledge and respect positions, titles, and rules  however, see it as a challenge to find a way around the rules. value peer bonding (e.g. organized team sports, church groups, clubs)  banding together to date and socialize rather than pairing off  work well in groups, preferring this to individual endeavors be quite technologically savvy (self-taught from experimenting and exploring)  computers, internet, smart phones, pocket pc

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American College Health Association (ACHA) National College Health Assessment (NCHA) The largest known and most comprehensive data set on the health of college students Initiated in 2000 Revised in 2008 (NCHA II) Last given at FGCU, Fall 2009

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NCHA II Survey - Mental Health continued 75.1% of students found some aspect of their life being traumatic or very difficult to handle in the last 12 months (77.3%) 44.9% reported Academics (47.5%) 27.3% reported Family problems (30.7%) 32.3% reported Intimate relationships (36.5%) 35.4% reported Finances (43.6%) 24.4% reported Sleep difficulties (31.6%)

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NCHA II Survey - Sleep Only 58.6% of students reported getting enough sleep to feel rested in 3 or more mornings of the past 7 days (56.8%) 60.5% of students reported feeling tired, dragged out or sleepy during the day for 3 or more days of the past 7 days (63.5%) NCHA II Survey - Stress 50.7% of students rated their level of stress as above average or tremendous within the last 12 months (51.2%)

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NCHA II Survey – Alcohol & Other Drug Use 2008-Present Number of drinks consumed that last time students “partied” or socialized – Median of 4 (4) 33.1% of student reported binge drinking (five or more drinks per sitting) within the past 2 weeks (27.9%) Substance Used (within last 30 days) Actual UsePerceived Use Alcohol63.7% (62.9%)94.3% (97.1%) Marijuana14.0% (9.8%)78.2% (88.9%) All Other Drugs13.6% (12.9%)76.6% (87.9%)

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CORE Survey Developed by the Department of Education Published by the CORE Institute University Southern Illinois Measures alcohol and drug usage attitudes, related events and perceptions of students Completed online

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Norm Survey: Attitude Toward Alcohol Response Options: a. Drinking is never a good thing to do b. Drinking is all right but a person should not get drunk c. Occasionally getting drunk is OK as long as it does not interfere with academics or other responsibilities d. Occasionally getting drunk is OK even if it does interfere with academics or responsibilities e. Frequently getting drunk is OK if that’s what the individual wants to do.

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Norm Survey: Attitude Toward Alcohol Response Options: a. Drinking is never a good thing to do (.3%) b. Drinking is all right but a person should not get drunk (5.0%) c. Occasionally getting drunk is OK as long as it does not interfere with academics or other responsibilities (52.1% - median) d. Occasionally getting drunk is OK even if it does interfere with academics or responsibilities (20.5%) e. Frequently getting drunk is OK if that’s what the individual wants to do (22.1%)

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Reference Group Consumed alcohol in past year 85%81%83%84% Consumed alcohol in past 30 days 72%69%64%72% Under age consumed in past 30 days 68%65%54%68% Binge drinking in previous 2 weeks 36%38%37%47% Average # drinks a week Driven Under the influence 31% 18%27%26% FGCU CORE Survey Comparison

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2008 CORE Survey Illegal Drug Use (2004 Comparisons) Marijuana 28.7 % used in past year (30.6%) 14.8% used this past 30 days (17.5 %) 11.4% used illegal drug other than marijuana in past year (16.0%) 4.2% used illegal drug other than marijuana in past 30 days (5.3%)

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Parent Tips If your student is sick, tell them to go to the health center first (its free, accessible and good first response) If they are told to take pain relievers, drink fluids, and get plenty of rest, tell them that is a good thing Remind them about Nurse Response for non-service hours Remind them there are cost recovery charges for tests and medications Remind daughters to keep up with female health exams Ask them if they are keeping up with sleep and dietary needs (remind them there are free nutritionist services)

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Student Survey of Health Services * 77% agreed the Student Health Center is their usual source of care and/ or primary care provider while enrolled at FGCU * 85% was satisfied with the ease of scheduling an appointment that meets their needs * 89% was satisfied with the efficiency of the check-in and check- out process * 91% was satisfied that the provider listened carefully to their concerns * 94% was satisfied that their confidentiality and privacy were carefully protected * 83% was satisfied with their overall visit at Student Health Services * 84% agreed they are very likely to recommend the health service to another student

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The National Survey of Counseling Center Directors (NSCCD) of 2009 Conducted since 1981 Data provided by administrative heads of college and university counseling centers in the United States & Canada Designed to stay abreast of current trends in counseling centers

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NSCCD 2009 Survey Highlights The 302 centers surveyed represent 2.6 million students who are eligible for counseling services at their institutions. 6.1% of centers charge for personal counseling, down from a peak of 17.2% in Only 1.7% of centers collect third party payments. 10.4% of enrolled students sought counseling in the past year. This represents approximately 270,000 students from the surveyed schools. The ratio of counselors to students in 1 to 1,527. The average number of counseling sessions for all students is 6.2 sessions per client. 61% of the surveyed directors have access to on-campus psychiatric consultation.

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2009 NSCCD Findings 93.4% of directors report that the recent trend toward greater number of students with severe psychological problems continues to be true on their campuses. Directors report that 48.4% of their clients have severe psychological problems. 7.4% of these have impairment, so serious, that they cannot remain in school or can only do so with extensive psychological/psychiatric help 40.9% experience severe problems but can be treated successfully with available treatment modalities. 60.6% increased the amount of time training faculty and others to respond in a helpful way to students in trouble and to make appropriate referrals. 53% expanded external referral networks.

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2009 NSCCD Findings continued 48.7 % provide psycho-educational assistance on center websites. 47.4% increased training for staff in working with difficult cases. 28.5% increased counseling center staff. 260 centers hospitalized an average of 8.5 students per school (2,200 students in all) for psychological reasons. The average number of hospitalizations per 1,000 students was % of directors describe their centers as primarily a mental health/psychological services center.

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2009 NSCCD Findings continued Directors reported 103 suicides in the past year.95.5% of centers maintain the right to refuse treatment to a student whose problems appear to be beyond the capability of the center to handle. However, 46% of responding directors report that they would not deny service in such cases if the student refused an outside referral and demands to be seen at the center. 87% contribute to freshman orientation programs

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Purpose of the study: Use quantitative research with a large sample size to explore 2 important questions:  Is mental illness on the rise in emerging adults?  What model might best explain such a rise in mental illness?

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Meta-Analysis What is a meta-analysis?  A research method that combines the results of several studies to address related research hypotheses.  This meta-analysis used mean scores that are reported as T-scores on the MMPI measures. This meta-analysis looked at data from the MMPI, MMPI-2, and MMPI- A for the years 1938 through 2007 ( for the MMPI-A).  In total, this study included 117 samples of 63, 706 college students and 14 samples of 13,870 high school students.  High school students were included to confirm data found in college populations and attempt to rule out population changes in college samples.  While the study may have included students who were seen at counseling centers, to be included in the meta-analysis, a study had to report means for all students, not those chosen for high/low scores, being current clients, or otherwise indicating maladjustment.

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What is the MMPI (MMPI-2, MMPI-A)? The MMPI is a widely used personality inventory that is designed to assess individual personality structure and psychopathology.  It was first published in 1943 and was originally developed to aid psychologists and psychiatrists assign appropriate diagnostic labels.  One of the most commonly used personality tests in the United States.  Items were chosen because they differentiated “normals” from clinical groups.  The MMPI was revised and updated norms were calculated for the MMPI-2, published in The current meta-analysis looked at data in reference to 8 clinical scales, 2 non-clinical scales, and 3 validity scales:

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Hypotheses and Models The authors believed they might find increases in psychopathology based on findings of previous research. If those increases were indeed found, the authors wanted to test three potential explanatory models: The extrinsic versus intrinsic goals model The economic cycles model The response bias model (psychopathology is more socially acceptable)

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Results *Keep in mind a mean of 50 and a SD of 10 for the MMPI; 2 or more SD above the mean is considered clinically significant.* MMPI clinical scale scores rose steadily between 1938 and 2007 – US college students scored more than a SD higher on the F scale, Pd, Pa, Sc, and Ma scales. US college students score more than ¾ of a SD higher on Hy, D, and Pt scales. US college students scores.45 of a SD higher on Hs. In 1938, 1 – 5% of students scored above a 70 on the clinical scales (this represents a significantly elevated score, 2 SD above the mean)…by 2007, 40% scored above 70 on Ma, 33% on Sc, 28% on Pd, 19% on Pt, 19% on F, 18% on Pa, 10% on Hy, 8% on D, & 6% on Hs.  These results were confirmed in the high school sample.

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In plain language: (Ma) – more students are characterized by unrealistically positive self-appraisal, overactivity, and low self-control. (Sc) – more students feel isolated and misunderstood. (Pa) – more students may be described as sensitive and sentimental. (Pd) – more students are narcissistic, self-centered, and antisocial or do not follow the rules and standards of society. General symptoms of anxiety are on the rise. (D, Hs, Hy, & Pt) – more students report worry, sadness, and dissatisfaction, and may express these through physical symptoms. (F) – more students are predicted to experience moodiness, restlessness, dissatisfaction, and instability.

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Which model best fits the data? The extrinsic versus intrinsic model -- linear increase in MMPI scores…each successive generation showed an increase. This suggests that a shift in American culture toward materialism, individualism, unrealistic expectations, and unstable relationships may account for the increase in psychopathology in young people. -Young American’s focus on extrinsic goals is increasing. -Developing a meaningful philosophy of life is less important. -Divorce is indirectly impacting our young people. “At the very least, college campuses now have a larger percentage of students with more serious mental health problems”

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Suicide Facts in the General Population In America 30,000 die from suicide Every day 80 Americans take their own lives Every day 1,500 Americans attempt suicide 11 th Leading cause of death 3 rd Leading cause of death among 15 – 24 year old group

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Center for Disease Control and Prevention (CDC) Developed National Violent Death Reporting System (NVDRS) Over 50,000 violent deaths in the US annually Started out with 7 states (up to 18 this year) First data from 2003 Majority (56.6%) of deaths were suicide (latest data from 2007 and 16 states) Followed by homicides at 28% Most frequent method was firearms Occurred at higher rate among males, native Americans, non-Hispanic whites and persons ages 45-54

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College Student Suicide Facts Suicide is the 2 nd Leading Cause of Death for College Students According to JED Foundation and NMHA over 1,000 College Students Die Each Year from Suicide Rate of Suicide is 7.5/100,000 Students

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Do’s and Don’ts DO: Stay in touch; encourage; be realistic; allow space DON’T: Panic; tell them what to do; take over and assume Responsibility; insist on frequent visits or phone calls; press your child on what they will do after school

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Parent Tips (developing the supportive partnership) If your student has had psychological issues that required counseling/therapy and/or psychiatric medication, refer them to CAPS from the start Find out if going to college is fulfilling their goals. Are they happy?(monitor don’t over react) Ask about what they are discovering in terms of a career (it is OK to change) Ask about how their relationships are going. Ask them how they are eating and sleeping (seriously!). Ask about the pressure and stress they are feeling. Try to help them see through it and be supportive

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Parent Tips (cont’d) Suggest they go to the CAPS website and take whatever screening they think is relevant to how they feel. Normalize the idea of seeking help let them know it is not a sign of weakness Suggest they go see a counselor or therapist in CAPS. They can come just once to consult with a CAPS professional to see what we think or might suggest. Tell them you understand college students drink, but that you would hope that it does not interfere in their academic or social life or put them or their friends at risk (explain what you mean)

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Student Survey of CAPS Counseling Services 96% agreed they were comfortable using CAPS services, would use them again and would refer others to CAPS 92% agreed that their counselor honestly cared about them 86% agreed they were better able to understand themselves 88% agreed they were able to better deal with their concerns/problems 86% agreed counseling had a positive effect on their overall campus experience ** 64% agreed that counseling made them better able to focus on academic and study requirements 62% agreed that counseling made it possible for them to continue as a student at FGCU **